Organization Active NPI

Dr. William Bradley

  • Optometrist
  • Mobile, AL
National Provider Identifier
1508928664
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR. WILLIAM BRADLEY
Practice address
3291 Bel Air Mall
Mobile, AL 36606-3207
Phone
(251) 476-2015
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. William Bradley, ODNPI 1952461279
Title
Owner
Phone
(251) 476-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3291 Bel Air Mall
Mobile, AL 36606-3207

Mailing address

3291 Bel Air Mall
Mobile, AL 36606
Phone (251) 476-2015

Other names 1

  • Bradley EyeCare and Associates Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051020000961 AL Part B Supplier - Clinic/Group Practice 2062438872 Receives reassigned benefits from 2 practitioners
Practice locations: Mobile, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1508928664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3291 BEL AIR MALL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "36606",
            "telephone_number": "251-476-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3291 BEL AIR MALL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063207",
            "telephone_number": "251-476-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. WILLIAM BRADLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-476-2015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradley EyeCare and Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.